Clinical therapeutics
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Clinical therapeutics · Jun 2001
Meta AnalysisMeta-analysis comparing newer antipsychotic drugs for the treatment of schizophrenia: evaluating the indirect approach.
Meta-analysis is a useful method to assess the efficacy of newer antipsychotic drugs compared with older drugs or placebo. However, few trials directly compare novel drugs to each other. ⋯ An indirect meta-analysis of studies comparing olanzapine with haloperidol and risperidone with haloperidol yielded conclusions similar to those found in a direct comparative RCT of olanzapine and risperidone.
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Clinical therapeutics · Jun 2001
ReviewEntacapone: a catechol-O-methyltransferase inhibitor for the adjunctive treatment of Parkinson's disease.
When levodopa therapy is used in Parkinson's disease, degradation of the drug in the peripheral nervous system is associated with dyskinesias and motor fluctuations. Much of this degradation is produced by catechol-O-methyltransferase (COMT), an enzyme involved in the metabolism of catecholamines and catechol compounds. Inhibition of COMT activity prolongs the action of levodopa and reduces fluctuations in response. Entacapone is a selective inhibitor of COMT whose activity is primarily in the peripheral nervous system, with little effect in the central nervous system. ⋯ In clinical trials, adjuvant treatment with entacapone appeared to be an effective and well-tolerated therapeutic strategy in patients with Parkinson's disease who experience fluctuations in the response to levodopa therapy. The increased elimination half-life of levodopa with concomitant entacapone results in greater and more sustained plasma levodopa levels, with more constant dopaminergic stimulation in the brain and greater amelioration of parkinsonian symptoms.
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Clinical therapeutics · Jun 2001
Comparative StudyEfficacy of single-dose intravenous dolasetron versus ondansetron in the prevention of postoperative nausea and vomiting.
Postoperative nausea and vomiting (PONV) is a significant problem in surgical patients. The 5-hydroxytryptamine3-receptor antagonists ondansetron, dolasetron, and granisetron are being used to prevent PONV and avoid the adverse events associated with traditional antiemetics such as antihistaminic agents, anticholinergic agents, and dopamine antagonists. ⋯ There were no significant differences in efficacy between single doses of i.v. dolasetron 12.5 mg and i.v. ondansetron 4 mg in the prevention of PONV.